Resumo Objetivo Descrever os casos suspeitos/confirmados de maus-tratos infantis relacionados a fraturas, atendidos em um hospital pediátrico no Sul do Brasil. Método Estudo das notificações do Sistema de Informação de Agravos de Notificação e dos prontuários das vítimas, entre janeiro/2016 e dezembro/2020. Avaliadas variáveis relacionadas à vítima, ao autor, à tipologia de maus-tratos, à presença de fraturas e sua localização anatômica e óbito. Regressão logística foi realizada para identificar as variáveis relacionadas à fratura, ajustada para sexo e idade, expressa em razão de chance e seus respectivos intervalos de confiança de 95%. Foi considerado significativo p < 0.05. Resultados Houve 276 casos, 73 lactentes (26,4%), predomínio do sexo masculino (151, 54,7%), com autoria dos maus-tratos por parentes (245, 96,0%), 85 (31,5%), apresentaram fraturas, sendo cinco óbitos (1,9%). Fatores relacionados à presença de fratura: idade da vítima (menor de dois anos; n = 82; RC 2,48; IC 95%: 1,45 - 4,25), ter mais de dois agressores envolvidos (n = 144; RC 2,09; IC 95%: 1,16 - 3,75), o meio ser trânsito/acidente automobilístico, (n = 52; RC 2,65; IC 95%: 1,04–6,75), consultar com ortopedista (n = 91; RC 6,77 / IC 95%: 3,66–12,51), e necessidade de intervenção cirúrgica (n = 15; RC 36,72; IC 95%: 8,22–164,03). Conclusões Ressaltada a importância da suspeição e identificação precoce da agressão, o preenchimento correto das notificações, para o acionamento do sistema de garantia de direitos e afastamento do agressor. suspeitosconfirmados suspeitos confirmados maustratos maus tratos Brasil vítimas janeiro2016 janeiro 2016 janeiro/201 dezembro2020 dezembro 2020 dezembro/2020 autor maustratos, tratos, óbito fratura 95 95% 005 0 05 0.05 27 7 26,4%, 264 26,4% , 26 4 (26,4%) 151, 151 (151 54,7%, 547 54,7% 54 54,7%) 245, 245 (245 96,0%, 960 96,0% 96 96,0%) 8 31,5%, 315 31,5% 31 5 (31,5%) 1,9%. 19 1,9% . 1 9 (1,9%) menor anos 82 2,48 248 2 48 145 45 1,4 4,25, 425 4,25 25 4,25) 144 2,09 209 09 116 16 1,1 3,75, 375 3,75 3 75 3,75) trânsitoacidente trânsito acidente automobilístico 52 2,65 265 65 1,04–6,75, 104675 1,04–6,75 04 6 1,04–6,75) 91 677 77 6,7 3,66–12,51, 3661251 3,66–12,51 66 12 51 3,66–12,51) 15 36,72 3672 36 72 8,22–164,03. 82216403 8,22–164,03 22 164 03 8,22–164,03) agressão agressor janeiro201 201 janeiro/20 dezembro202 202 dezembro/202 00 0.0 26,4 (26,4% (15 54,7 24 (24 96,0 31,5 (31,5% 1,9 (1,9% 2,4 14 1, 42 4,2 2,0 20 11 37 3,7 2,6 10467 1,04–6,7 67 6, 366125 3,66–12,5 36,7 367 8221640 8,22–164,0 janeiro20 janeiro/2 dezembro20 dezembro/20 0. 26, (26,4 (1 54, (2 96, 31, (31,5 (1,9 2, 4, 3, 1046 1,04–6, 36612 3,66–12, 36, 822164 8,22–164, janeiro2 janeiro/ dezembro2 dezembro/2 (26, ( (31, (1, 104 1,04–6 3661 3,66–12 82216 8,22–164 dezembro/ (26 (31 10 1,04– 366 3,66–1 8221 8,22–16 (3 1,04 3,66– 822 8,22–1 1,0 3,66 8,22– 3,6 8,22 8,2 8,
Abstract Objective To describe suspected/confirmed cases of child maltreatment related to fractures in a pediatric hospital in southern Brazil. Method Study of the Information System of Notifiable Diseases notifications and the victims’ medical records between January/2016 and December/2020. Variables related to the victim, the perpetrator, the type of abuse, the presence of fractures, and their anatomical location and death were evaluated. Logistic regression was performed to identify fracture-related variables, adjusted for sex and age. The results were expressed in odds ratios and their respective 95% confidence intervals. It was considered significant p < 0.05. Results There were 276 cases, 73 infants (26.4%), male predominance (151, 54.7%), with authorship of the mistreatment by relatives (245, 96,0%), 85 (31,5%), they presented fractures, with five deaths (1.9%). Factors related to the presence of fracture: age of the victim (less than two years old; n = 82; or 2.48; 95% CI: 1.45 - 4.25), having more than two aggressors involved (n = 144; or 2.09; 95% CI: 1.16-3.75), the medium being traffic/automobile accident, (n = 52; or 2.65; 95% CI: 1.04–6.75), consult an orthopedist (n = 91; or 6.77 / 95% CI: 3.66–12.51), and the need for surgical intervention (n = 15; OR 36.72; 95% CI: 8.22–164.03). Conclusions The importance of suspicion, early identification of aggression, and the correct completion of notifications for activating the system of guaranteeing rights and removal of the aggressor was emphasized. suspectedconfirmed suspected confirmed Brazil victims January2016 January 2016 January/201 December2020 December 2020 December/2020 perpetrator abuse evaluated fracturerelated fracture variables 95 intervals 005 0 05 0.05 27 7 26.4%, 264 26.4% , 26 4 (26.4%) 151, 151 (151 54.7%, 547 54.7% 54 54.7%) 245, 245 (245 96,0%, 960 96,0% 96 96,0%) 8 31,5%, 315 31,5% 31 5 (31,5%) 1.9%. 19 1.9% . 1 9 (1.9%) less old 82 2.48 248 2 48 CI 145 45 1.4 4.25, 425 4.25 25 4.25) 144 2.09 209 09 1.163.75, 116375 1.16 3.75 16 3 75 1.16-3.75) trafficautomobile traffic automobile accident 52 2.65 265 65 1.04–6.75, 104675 1.04–6.75 04 6 1.04–6.75) 91 677 77 6.7 3.66–12.51, 3661251 3.66–12.51 66 12 51 3.66–12.51) 15 36.72 3672 36 72 8.22–164.03. 82216403 8.22–164.03 22 164 03 8.22–164.03) suspicion aggression emphasized January201 201 January/20 December202 202 December/202 00 0.0 26.4 (26.4% (15 54.7 24 (24 96,0 31,5 (31,5% 1.9 (1.9% 2.4 14 1. 42 4.2 2.0 20 163 1.163.75 11637 116 1.1 375 3.7 1.16-3.75 2.6 10467 1.04–6.7 67 6. 366125 3.66–12.5 36.7 367 8221640 8.22–164.0 January20 January/2 December20 December/20 0. 26. (26.4 (1 54. (2 96, 31, (31,5 (1.9 2. 4. 1.163.7 1163 11 37 3. 1.16-3.7 1046 1.04–6. 36612 3.66–12. 36. 822164 8.22–164. January2 January/ December2 December/2 (26. ( (31, (1. 1.163. 1.16-3. 104 1.04–6 3661 3.66–12 82216 8.22–164 December/ (26 (31 1.163 1.16-3 10 1.04– 366 3.66–1 8221 8.22–16 (3 1.16- 1.04 3.66– 822 8.22–1 1.0 3.66 8.22– 3.6 8.22 8.2 8.